본 연구는 EMG(electromyography) 텍스타일 전극 개발을 목적으로 레이어 수의 디자인 및 원단을 다르게 하여 성능 및 신호 획득 안정성을 평가한다. 레이징 및 프레스 공정을 통하여 텍스타일 전극을 제조하며 Layer-0, Layer-1, Layer-2로 레이어 유무 및 수에 따른 결과를 분석했다. 이에 레이어 유무에 따라서는 근활성 측정에 영향을, 수가 많을수록 높은 성능이 나타남을 확인할 수 있었다. Layer-2 구조로 통일하여 5가지의 원단(네오프렌, 스판덱스 쿠션, 폴리에스테르 100%, 나일론 스판덱스, 광목 캔버스)으로 전극을 제조해 실험해 보았다. 성능적인 면에서, 원단의 중 량이 높은 나일론 스판덱스가 높은 성능을 보였으며, 스판쿠션 텍스타일 전극이 근활성도 수득에 높은 안정성을 보 였다. 이에 위 연구는 레이어에 따른 성능 연관성과 전극-피부사이의 닿는 면적 간의 관계 등을 고찰하여 슬리브 전체의 의복압을 늘리는 대신 특정 센서 측정 부위에만 높은 압력을 가함으로 차후 연구에서 레이어의 수 및 물성에 따른 전극의 공학적 설계 가능성을 제시한 의의가 있다.

Background: As ways to optimize the mobilization of postural stability muscles for sitting up motions, arm reaching motions and head raising motions have important effects. Objectives: This study was conducted to investigate the effects of reaching to sit-up training on the trunk muscle activity, postural ability, and balance ability of patients with hemiplegia due to stroke. Design: Randomized controlled trial. Methods: This study was conducted with 18 stroke patients who met the selection criteria divided into two groups: a study group of 9 patents and a control group of 9 patients. The study group carried out reaching to sit-up training, which can promote trunk muscles and improve control through trunk interactions. The control group received general physical therapy intervention Results: The activity of the trunk muscle was significantly different before and after intervention in study and control group. The functional reaching test showed significant changes in both the study group and the control group. The timed up and go test showed a significant change in the study group. Conclusion: Reaching to sit-up training for 4 weeks showed increases in trunk muscle activity in stroke patients and was effective in improving balance ability.

Background: A decrease in physical activity has been observed due to the global pandemic, resulting in the onset and progression of musculoskeletal disorders as chronic diseases. Objectives: This study aimed to assess the difference in the degree of contraction of the lower limb muscles between the existing vertical vibration method and a new cross-vibration method. Design: Randomized controlled trial. Methods: The exercise program using whole-body vibration equipment was conducted for 12 sessions, 25 min per session, three times per week for 4 weeks. Results: The changes over time showed a significant difference in cross-alternating vibrations (P<.05), except for the lateral gastrocnemius and tibialis anterior, with no significant difference in sonic vertical vibration (P>.05). The interaction between time and group was significant for all muscles (P<.05), except for the biceps femoris, with differences between before the program and at 2 and 4 weeks after the program revealed in the post-hoc analysis. Conclusion: Future studies should further evaluate the use of CAV exercise devices as auxiliary equipment in exercise by assessing different groups and variations in intensity.

Background: Bird dog exercise (BDE) is one of the lumbar stabilization exercises that rehabilitate low back pain by co-contraction of the local and global muscles. Previous studies have reported the effect of various type of BDEs (for example, practicing the exercises on various surfaces and changing the limb movement) for muscle co-contraction. Objects: This study aimed to investigate the effect of knee joint flexion position of the raised lower limb on abdominal and back muscle activity during BDE in patients with chronic low back pain (CLBP). Methods: Thirteen males participated in this study (age: 32.54 ± 4.48 years, height: 177.38 ± 7.17 cm). Surface electromyographic (SEMG) data of the internal abdominal oblique (IO), external abdominal oblique (EO), lumbar multifidus (MF), and thoracic part of the iliocostalis lumborum (ICLT) were collected in two knee joint flexion positions (90° flexion versus 0° flexion) during BDE. The SEMG data were expressed as a percentage of root mean square mean values obtained in the maximal voluntary isometric contraction. Results: Greater muscle activity of the IO (p = 0.001), MF (p = 0.009), and ICLT (p = 0.021) of the raised lower limb side and the EO (p = 0.001) and MF (p = 0.009) of the contralateral side were demonstrated in the knee joint flexion position compared to the knee joint extension position. Greater local/global activity ratios of the abdominal muscle (i.e., IO and EO) of the raised lower limb (p = 0.002) and the back muscle (i.e., MF and ICLT) of the contralateral side (p = 0.028) were also noted in the knee joint flexion position. Conclusion: BDE with a knee joint flexion position might be recommended as an alternative lumbar stabilization exercise to enhance muscle activity in both the raised lower limb and the contralateral sides of the trunk for individuals with CLBP

Background: The scapulo-thoracic musculatures including serratus anterior (SA), upper trapezius and lower trapezius can provide shoulder stability and functional shoulder movement. Objects: The muscle activities of upper and lower SA were compared during three different scapular protraction exercises in healthy individuals in sitting position. Methods: Twenty-five healthy subjects were participated. Electromyography device was used to measure muscle activity of upper and lower SA and trapezius muscles. Each subject was asked to perform three different scapular protraction exercises (scapular protraction [SP], SP with self-resistance [SPSR], SPSR with hand-exerciser [SPSRH]) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The muscle activity of lower SA muscle was significantly different among three conditions (SP vs. SPSR vs. SPSRH) (p < 0.01). The lower SA muscle activity was significantly greater during SPSRH compared to SP and SPSR, which required joint stability more than SP and SPSR (p < 0.01). Conclusion: SPSRH exercise can be recommended to facilitate the muscle activity of lower SA. In addition, the intramuscular variation in the upper and lower SA during scapular protraction exercise is required to consider the effective rehabilitation.

Background: Although the scapular posterior tilt movement could facilitate the lower trapezius (LT) muscle activity, no study identified the effects of the scapular posterior tilt movement on the selective activation of the LT muscle during prone shoulder extension. Objectives: To examine the influences of additional scapular posterior tilt on electromyography (EMG) of the upper trapezius (UT) and the LT muscles during prone shoulder extension. Design: Cross-sectional study. Methods: There were 15 asymptomatic male participants in this study who performed prone shoulder extension with and without scapular posterior tilt movements. For the scapular posterior tilt movements, participants performed visual biofeedback training for scapular movement using motion sensor. During the exercises, the EMG activity of the UT and LT was recorded using surface EMG system. Results: The EMG activity of the LT significantly increased during prone shoulder extension with scapular posterior tilt compared to that of general prone shoulder extension, whereas that of the UT was not significantly different between the two exercises. Moreover, scapular posterior tilt application significantly decreased UT/LT muscle activity ratio. Conclusion: Scapular posterior tilt movement may be emphasized during exercise when facilitating LT muscle activation.

Background: A hip fracture may occur spontaneously prior to the hip impact, due to the muscle pulling force exceeding the strength of the femur. Objects: We conducted falling experiments with humans to measure the activity of the hip muscles, and to examine how this was affected by the fall type. Methods: Eighteen individuals fell and landed sideways on a mat, by mimicking video-captured real-life older adults’ falls. Falling trials were acquired with three fall directions: forward, backward, or sideways, and with three knee positions at the time of hip impact, where the landing side knee was free of constraint, or contacted the mat or the contralateral knee. During falls, the activities of the iliopsoas (Ilio), gluteus medius (Gmed), gluteus maximus (Gmax) and adductor longus (ADDL) muscles were recorded. Outcome variables included the time to onset, activity at the time of hip impact, and timing of the peak activity with respect to the time of hip impact. Results: For Ilio, Gmed, Gmax, and ADDL, respectively, EMG onset averaged 292, 304, 350, and 248 ms after fall initiation. Timing of the peak activity averaged 106, 96, 84, and 180 ms prior to the hip impact, and activity at the time of hip impact averaged 72.3, 45.2, 64.3, and 63.4% of the peak activity. Furthermore, the outcome variables were associated with fall direction and/or knee position in all but the iliopsoas muscle. Conclusion: Our results provide insights on the hip muscle activation during a fall, which may help to understand the potential injury mechanism of the spontaneous hip fracture.

Background: Shoulder horizontal abduction in the prone position (SHAP) has been reported as an effective exercise to strengthen the lower trapezius. However, the effects of pre-emptive scapular posterior tilt on scapular muscle activity and scapulohumeral movements during SHAP have not been examined. Objectives: To examine the effect of the addition of scapular posterior tilt on muscle activity of the trapezius and posterior deltoid, and scapular posterior tilt and shoulder horizontal abduction, during SHAP. Design: Cross-sectional study. Methods: Fifteen healthy male subjects performed two types of SHAP: general and modified SHAP (SHAP combined with pre-emptive scapular posterior tilt). To perform modified SHAP, pre-emptive scapular posterior tilt training was performed prior to the modified SHAP. Muscle activity of the middle and lower trapezius and posterior deltoid, and the amount of scapular posterior tilt and shoulder horizontal abduction, were measured during two types of SHAP. Results: Muscle activity of the lower trapezius and scapular posterior tilt was significantly increased during the modified SHAP, while muscle activity of the posterior deltoid and the amount of shoulder horizontal abduction were significantly decreased. However, the middle trapezius muscle activity did not change during the modified SHAP. Conclusion: The SHAP with pre-emptive scapular posterior tilt can be useful to strengthen the lower trapezius.

Background: Based on the understanding of the muscle activation relationship between the infraspinatus and posterior deltoid muscles to according to the angle of motion during external rotation on glenohumeral joint, effective shoulder joint strengthening exercise for the prevention and rehabilitation of shoulder injury due to muscle strength imbalance can be performed by achieving the ideal muscle activity ratio during exercise. Objectives: To compare and analyze the muscle activation changes and activity ratio of the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle. Design: Quasi-randomized trial. Methods: The study included 48 healthy male and female adults who provided informed consent for participation in the study. All the subjects performed isometric glenohumeral external rotation by setting the angle of motion to 30°, 45°, and 60° using a 5 kg resistance weight pulley. On surface electromyography, the differences in muscle activation and activity ratio between the infraspinatus and posterior deltoid muscles were investigated. Results: A significant difference in muscle activation was found in the comparison between the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle (P<.05). The muscle activation levels of the infraspinatus and posterior deltoid muscles were highest at the external rotation angles of 30° and 60°, respectively. The muscle activity ratio between the infraspinatus and posterior deltoid muscles also showed a significant difference (P<.05) and was highest at the shoulder external rotation angle of 30°. Conclusion: The findings of this study suggest that muscle activity is the highest at the shoulder external rotation angle of 30° in healthy individuals.

목적 : 본 연구는 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련이 뇌졸중 환자의 상지기능, 상지의 근 활성도, 일상생활 활동과 삶의 질에 미치는 효과를 분석하고자 한다. 연구방법 : 선착순 무작위 대조 실험연구 방식으로 연구를 진행하였다. 의료연구협의회 지표(medical research council scale), 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination; MMSE-K)로 대상자를 선별하여 뇌졸중 환자 31명을 무작위로 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련군과 일반적 작업치료군으로 나눈 뒤, 주 5회 하루 30분씩 총 25회기 동안 실험을 진행하였다. 중재 전ᆞ후 비교 분석을 하기 위해서 뇌졸중 상지 기능평가(Manual Function Test; MFT), 표면 근전도 검사(Surface Electromyography; EMG), 한국판 수정된 바델지수(Korean version of Modified Barthel Index; K-MBI), 뇌졸중 영향 척도 3.0(Stroke Impact Scale 3.0; SIS)을 사용하였다. 결과 : 첫째, 실험군과 대조군에서 상지의 기능향상(MFT)이 있었고, 실험군에서 위팔노근의 근 활성도에 유 의한 향상이 있었다. 둘째, 일상생활활동에서는 실험군과 대조군에서 유의한 향상을 보였다. 셋째, 삶의 질 에서는 실험군에서 유의한 향상이 있었다. 결론 : 스마트 글러브를 이용한 가상현실 기반 상지재활훈련은 뇌졸중 환자의 상지기능, 근 활성도, 일상생활 활동과 삶의 질을 향상하는 효과적인 작업치료 방법이다.

Background: Early rehabilitation after partial meniscectomy is important to recover the balance of the vastus medialis oblique and vastus lateralis and prevent pathological problems in the lower extremities and the whole body. Objective: To compare muscle activations for patients after partial meniscectomy. Design: Dual-group Pretest-Posttest Design from the Quasi-Experimental Research. Methods: Twenty participants after partial meniscectomy were recruited and were randomly divided into a Q-setting sensorimotor training group (QSMTG) and Q-setting exercise group (QSEG). Muscle activity of the vastus medialis oblique and vastus lateralis was measured before and after intervention. Results: In the two groups, the vastus medialis oblique and vastus lateralis activations increased significantly (P<.05). The Q-setting sensorimotor training group showed more increases than the Q-setting exercise group, and there were significant differences between the groups (P<.05). The activation ratio of the vastus medialis oblique and vastus lateralis had increasingly significant differences in the Q-setting sensorimotor training group (P<.05), and there were no significant differences between the groups (P>.05). Conclusion: Q-setting exercise with sensorimotor training was a useful method that improved the balance of vastus medialis oblique (VMO) and vastus lateralis (VL) activity after meniscectomy.

Background: Lower trapezius muscle function is important for the prevention and treatment of shoulder injuries. However, scapular posterior tilt movement has been overlooked in lower trapezius strengthening exercise programs. Objective: To examine the effects of prone arm lifting with scapular posterior tilt (PALSPT) on trapezius muscles. Design: Crossover study Methods: 17 healthy males were recruited for participation in this study. Participants performed backward rocking diagonal arm lifting (BRDAL) and PALSPT. To train participants in scapular posterior tilt movements for PALSPT, visual biofeedback of scapular movements was provided using a motion sensor. Electromyography (EMG) activities of the middle and lower trapezius were recorded using a surface EMG system. Differences in middle and lower trapezius muscle activity between BRDAL and PALSPT exercises were analyzed. Results: Lower trapezius muscle activity was significantly greater during PALSPT than during BRDAL (p=.006). Although greater EMG activity was observed in the middle trapezius during PALSPT than during BRDAL, this difference was not significant (p=.055). Conclusions: The results of the present study indicate that scapular posterior tilt movements must be considered in lower trapezius muscle strengthening programs.

목적 : 증식당뇨망막병증과 같은 망막질환은 시력상실에 이르게 하는 현대 눈 질환 중 가장 중요한 질환이다. 본 논문에서는 산화스트레스와 관련된 망막변성과 같은 혈관리모델링을 유발하는 혈관평활근세포(vascular smooth muscle cell, VSMC)의 활성화에 대한 4-hydroxynonenal(HNE)의 중요성에 대해 고찰하고자 한다. 방법 : 망막질환은 비정상적 혈관신생의 특징이 있으며 이는 세포증식과 세포자살의 증가와 관련되어 있다. 증식당뇨망막병증에 있어 혈관신생은 기존에 존재하고 있는 혈관으로부터 새로운 모세혈관들이 자라나는 복잡한 단계의 현상이다. 따라서 우리는 이와 같은 혈관리모델링을 유발하는데 있어 HNE의 VSMC의 활성화에 대한 역할을 조사하였다. 결과 : HNE는 VSMC에서 nitro oxide(NO)의 생성을 증가시켰다. HNE는 세포구조의 교란과 다양한 산화스 트레스 관련 퇴행과정을 일으킴으로써 혈관기능이상에 이르게 한다. 또한 HNE는 protein kanse B(Akt)의 인산화를 증가시켰다. HNE에 의한 산화스트레스는 Akt 인산화와 세포증식의 유발에 있어 중재자의 역할을 하는 것으로 사료된다. 결론 : HNE에 의한 산화스트레스는 망막동맥경화의 발병과 혈관신생과 같은 혈관의 교란에 중요한 역할을 하는 것으로 사료된다. HNE의 VSMC 활성화에 대한 역할은 산화스트레스 관련 망막변성에 있어 혈관리모델링의 촉진과 발달에 중요한 역할을 하는 것으로 사료된다.

Background: Despite muscle latency times and patterns were used as broad examination tools to diagnose disease and recovery, previous studies have not compared the dominant arm to the non-dominant arm in muscle latency time and muscle recruitment patterns during reaching and reach-to-grasp movements. Objects: The present study aimed to investigate dominant and non-dominant hand differences in muscle latency time and recruitment pattern during reaching and reach-to-grasp movements. In addition, by manipulating the speed of movement, we examined the effect of movement speed on neuromuscular control of both right and left hands. Methods: A total of 28 right-handed (measured by Edinburgh Handedness Inventory) healthy subjects were recruited. We recorded surface electromyography muscle latency time and muscle recruitment patterns of four upper extremity muscles (i.e., anterior deltoid, triceps brachii, flexor digitorum superficialis, and extensor digitorum) from each left and right arm. Mixed-effect linear regression was used to detect differences between hands, reaching and reach-to-grasp, and the fast and preferred speed conditions. Results: There were no significant differences in muscle latency time between dominant and non-dominant hands or reaching and reach-to-grasp tasks (p>.05). However, there was a significantly longer muscle latency time in the preferred speed condition than the fast speed condition on both reaching and reach-to-grasp tasks (p<.05). Conclusion: These findings showed similar muscle latency time and muscle activation patterns with respect to movement speeds and tasks. Our findings hope to provide normative muscle physiology data for both right and left hands, thus aiding the understanding of the abnormal movements from patients and to develop appropriate rehabilitation strategies specific to dominant and non-dominant hands.

The purpose of this study was to investigate the effects of squat exercises with an upper limb resistance movement on the vastus medialis oblique, vastus lateralis, and gluteus maximus. This study recruited 16 healthy men. All subjects performed squat exercises with and without upper Limb resistance movements by using elastic tubing band. Electromyography (EMG) activity of the vastus medialis oblique, vastus lateralis, and gluteus maximus was recorded using a surface EMG system during these isometric squat exercises in both experimental conditions. The different muscle activation of the vastus medialis oblique, vastus lateralis, and gluteus maximus between the squat exercises with and without the upper limb resistance movement was analyzed using a paired t-test or Wilcoxon signed rank test. Our findings showed that the vastus medialis oblique, vastus medialis oblique/vastus lateralis ratio and gluteus maximus muscle activity was significantly increased during the squat exercise with upper limb resistance movements, as compared to the squat exercise without this component (p < .05). Based on our findings, the additional upper limb resistance movement may be a useful strategy to facilitate the vastus medialis oblique and gluteus maximus muscle activation during a squat exercise.

Background: Methods for exercising serratus anterior (SA) and upper trapezius (UT) muscles are important for the recovery of patients with various shoulder disorders, yet the efficacy of closed or open kinetic chain exercises have not yet been evaluated. Objects: The purpose of this study was to compare the activation of the SA and UT muscles during scapular protraction considering both closed and open kinetic chain exercises. Methods: Thirty subjects were randomly divided into experimental groups (closed kinetic chain exercise) and control groups (open kinetic chain exercise) in which scapular protraction was performed at 90° or 125° shoulder flexion. Electromyographic activity data were collected from the SA and UT muscles per position and exercise method. Results: Separate mixed 2-way analysis of variance showed significant differences in the activation of the SA (F1,28=6.447, p=.017) and the UT (F1,28=35.450, p=.001) muscles between the groups at 90° and 125° shoulder flexion. Also, the SA/UT ratio measures at 90° and 125° shoulder flexion significantly differed between the groups (F1,28=15.457, p=.001). That is, the closed chain exercise was more effective than open chain exercise for strengthening the SA muscle and controlling the UT muscle, 125° of shoulder joint was more effective than 90°. Conclusion: The findings suggest that scapular protraction with shoulder 125° flexion at the closed kinetic chain exercise may be more effective in increasing SA muscle activation and decreasing UT muscle activation as well as increasing the SA/UT ratio than open kinetic chain exercise.

Muscle atrophy is characterized by a decrease in the mass of the muscle. With an increase in life expectancy and chronic illnesses, the incidence of muscle atrophy is increasing and the quality of life of patients is decreasing. Thus, reducing muscle atrophy is of high clinical and socio-economic importance. Mistletoe is a semi-parasitic plant that has been used as a traditional medicine in many countries to treat various human illnesses. It has been reported that Korean mistletoe extract (KME) has diverse biological functions including anti-tumor, anti-oxidant, anti-diabetic, anti-obesity properties, and extension of lifespan. Especially, we have recently reported that KME improves exercise endurance in mice, indicating its beneficial roles in enhancing the capacity of skeletal muscle. In this study, we investigated whether KME could activate the signaling pathway related to protein synthesis in a mouse model of muscle atrophy. Interestingly, KME efficiently activated the Akt/mTOR pathway, and Akt and mTOR are important signaling hub molecules for the acceleration of protein synthesis in muscle cells. In addition, KME also increased the activity of S6 kinase which is involved in the regulation of muscle cell size. Moreover, the ERK activity, required for transcription of ribosomal RNA for protein synthesis, was also enhanced in KME-treated mouse muscle. These data support the idea that KME increases muscle mass via increased protein synthesis. Our findings also suggest that Korean mistletoe might be a promising candidate for the development of functional foods that are beneficial for preventing muscle atrophy.

This study aims to investigate the effects of ankle foot orthosis(AFO) on the activities of tibialis anterior(TA), soleus(Sol), rectus femoris(RF) and biceps femoris(BF) during stairs descending. The activities of TA, Sol, RF and BF were initially measured while descending 4 stairs without using AFO. The activities of the same muscles were then measured again while descending 4 stairs while using AFO. Wilcoxon signed-rank tests were used to analyze the results in order to examine the differences between the with using AFO and without using AFO. Although the activities of TA, Sol and RF were relatively lower while using AFO than without using AFO, only the differences in Sol and RF activities were significant(p<0.05). The activity of BF was relatively higher while using AFO compared to the activity of BF observed without using AFO. However, difference was not significant(p>0.05). Conclusion of this study was observed since AFO’s ground reaction force absorption during stairs descending reduced the need to use So and RF that is related to shock absorption. BF activity was increased with AFO than without during standing forward to correct the trunk stability.

The purpose of this study was to investigate the effects of visual electromyography (EMG) biofeedback on the EMG activity of the lower trapezius (LT), serratus anterior (SA), and upper trapezius (UT) muscles, the LT/UT and SA/UT EMG activity ratios, and the scapular upward rotation angle during scapular posterior tilting exercise (SPTE). Twenty-four subjects with round-shoulder posture participated in this study. The EMG activities of the LT, SA, and UT were collected during SPTE both without and with visual EMG biofeedback. The scapular upward rotation angle was measured at the baseline, after SPTE without visual EMG biofeedback, and after SPTE with visual EMG biofeedback. The LT, SA, and UT EMG activities, and the LT/UT and SA/UT EMG activity ratios were analyzed by paired t-test. The scapular upward rotation angle was statistically analyzed using one-way repeated analysis of variance. If a significant difference was found, a Bonferroni correction was performed (p=.05/3=.017). The EMG activities of LT and SA significantly increased, and the EMG activity of UT significantly decreased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). In addition, the LT/UT and SA/UT EMG activity ratios significantly increased during SPTE with visual EMG biofeedback compared to SPTE without visual EMG biofeedback (p<.05). Significant increases were found in the scapular upward rotation angle after SPTE without and with visual EMG biofeedback compared to baseline (p<.017), and no significant differences were observed in the scapular upward rotation angle between SPTE without and with visual EMG biofeedback. In conclusion, SPTE using visual EMG biofeedback may be an effective method for increasing LT and SA activities while reducing UT activity.

Objective : The purpose of this study was to investigate the effects of Expiratory Muscle Strength Training (EMST) on the suprahyoid muscle activation and swallowing function of stroke patients.Methods : This study randomly assigned 21 stroke patients to an experimental group and a control group. Four-week EMST was performed at resistance of 70% of the maximum expiratory pressure with the experimental group and at resistance of 20% of that with the control group. Evaluation was conducted using surface Electromyographic (sEMG), Videofluoroscopic Dysphagia Scale (VDS), and Penetration-Aspiration Scale (PAS) based on Videofluoroscopic Swallowing Study (VFSS).Results : There was a statistically significant difference in the activation of the suprahyoid muscles using sEMG of the experimental group (p<.05) while there was no significant difference in that of the control group. Both group showed significant difference in the pharyngeal phase of VDS and PAS. Also in the comparison of variation in VDS and PAS before and after the intervention, there were statistically.Conclusion : Finding from this study confirmed that EMST applied 70% maximum expiratory resistance would be a remedial method which could help activate pharyngeal dysphagia patients’ suprahyoid muscles and improve swallowing function.